Silva et al. conducted an interesting rs-fMRI study on patients with disorders of consciousness (DOC), showing that the strength of functional connectivity between the precuneus and medial frontal cortex is a significant predictor of recovery from coma three months after disease onset. [1] In our cohort of adult DOC patients with long disease duration (>100 patients, time from acute event from 2 to 252 months), we confirmed that preservation of long-range synchronization, measured with different data-analysis approaches, can differentiate vegetative (VS) from minimally conscious state (MCS) patients. [2] The study by Silva et al. is important as it suggested functional connectivity integrity might have some diagnostic, and also prognostic, value. [3]

An important goal for future work is to confirm these findings in a larger cohort, including hemorrhagic and ischemic aetiologies. Additionally, it remains to be clarified how DOC patients exhibiting "late recovery" of responsiveness fare in terms of network integrity; [4,5] in this regard, a longer follow-up period is relevant to detect such cases.